5 Tips to Get a Long-Term-Care Insurer to Pay Up
What you need to know to get through the claims process smoothly.

A long-term-care insurance policy can help cover the costs of care in a nursing home, an assisted-living facility or at home. Follow these steps, and you’re more likely to get through the claims process smoothly.
1. Find out what triggers benefits. Most policies pay only if the patient needs help with at least two out of six activities of daily living (such as bathing or dressing) or there is evidence of cognitive impairment. But the requirements for making a claim vary. Work with your parent’s doctor to provide the information the insurer needs.
2. Find out about home-care requirements. If you plan to provide care at home for your parent, call the insurer to find out about requirements for payouts -- especially before you hire a caregiver to come into the home. Some insurers require home caregivers to be licensed or from an agency, for example. A few pay benefits even to relatives who provide care. Many insurers have care coordinators who can help you search for caregivers or facilities.

Sign up for Kiplinger’s Free E-Newsletters
Profit and prosper with the best of expert advice on investing, taxes, retirement, personal finance and more - straight to your e-mail.
Profit and prosper with the best of expert advice - straight to your e-mail.
3. Understand the waiting period. Most policies have waiting periods of at least 60 days. However, some companies have a zero-day waiting period for home care but a longer waiting period for assisted living or nursing homes. Others count every calendar day from the time your parent met the requirement for needing help with activities of daily living or the cognitive-impairment requirement, even if he or she didn’t receive care every day. Still others count only the days on which your parent received care -- which can extend the waiting period. To speed things up, you may want to have a caregiver come in for a shorter period for more days rather than a longer period for fewer days.
4. Keep track of the paperwork. That includes forms you submit and communications with the facility and the long-term-care insurer. Sometimes payouts are delayed because of paperwork issues. Keep records of all phone calls and dates that you or the doctor or the facility sent information, and follow up to make sure the paperwork has been received. Also ask your insurer or agent if there is anything you can do to streamline the paperwork; some insurers will arrange direct billing between the nursing home and insurer.
5. Appeal a denied claim. If you have a dispute, work through the insurer’s appeals process, and contact your state insurance department for help.
Profit and prosper with the best of Kiplinger's advice on investing, taxes, retirement, personal finance and much more. Delivered daily. Enter your email in the box and click Sign Me Up.

As the "Ask Kim" columnist for Kiplinger's Personal Finance, Lankford receives hundreds of personal finance questions from readers every month. She is the author of Rescue Your Financial Life (McGraw-Hill, 2003), The Insurance Maze: How You Can Save Money on Insurance -- and Still Get the Coverage You Need (Kaplan, 2006), Kiplinger's Ask Kim for Money Smart Solutions (Kaplan, 2007) and The Kiplinger/BBB Personal Finance Guide for Military Families. She is frequently featured as a financial expert on television and radio, including NBC's Today Show, CNN, CNBC and National Public Radio.
-
Amtrak Joins Prime Day With Deals on Fares — But You’ll Have to Act Fast
Prime members can score 20% off midweek fares — what travelers should know before booking.
-
Mississippi Tax-Free Weekend 2025 Is Here: What to Know Before You Shop
Tax Holiday Just in time for Prime Day, Mississippi is celebrating a tax holiday in July. Find out how you can save on back-to-school essentials.
-
Amazon Resale: Where Amazon Prime Returns Become Your Online Bargains
Feature Amazon Resale products may have some imperfections, but that often leads to wildly discounted prices.
-
Roth IRA Contribution Limits for 2025
Roth IRAs Roth IRA contribution limits have gone up. Here's what you need to know.
-
Four Tips for Renting Out Your Home on Airbnb
real estate Here's what you should know before listing your home on Airbnb.
-
Five Ways to a Cheap Last-Minute Vacation
Travel It is possible to pull off a cheap last-minute vacation. Here are some tips to make it happen.
-
How Much Life Insurance Do You Need?
insurance When assessing how much life insurance you need, take a systematic approach instead of relying on rules of thumb.
-
When Is Amazon Prime Day? Everything We Know, Plus the Best Deals on Apple, Samsung and More
Amazon Prime Amazon Prime Day is four days this year. Here are the key details you need to know, plus some of our favorite deals to shop during the sale.
-
How to Shop for Life Insurance in 3 Easy Steps
insurance Shopping for life insurance? You may be able to estimate how much you need online, but that's just the start of your search.
-
Five Ways to Shop for a Low Mortgage Rate
Becoming a Homeowner Mortgage rates are high this year, but you can still find an affordable loan with these tips.